ObjectiveThis study aimed to revise the perioperative recovery scale for integrative medicine (PRSIM) based on item response theory (IRT). MethodsUnder the guidance of IRT, a total of 349 patient data collected during the development of the original version of PRSIM at Guangdong Provincial Hospital of Chinese Medicine were used. Principal component analysis was performed using SPSS 18.0 software to test the unidimensionality. The R language was utilized for parameter estimation, including discrimination coefficient, difficulty parameters and information content, as well as drawing item characteristic curves to assess item quality and estimate item functioning differences. A comprehensive screening process was carried out by combining expert consultations, patient evaluations, and discussions within a core group. ResultsThe degree of discrimination of all items ranged from ?0.535 to 2.195. The difficulty coefficient ranged from ?10.343 to 5.461, and the average information content of all items ranged from 0.043 to 1.075. Based on the criteria for parameter selection, nine items were retained. The results of expert consultations indicated the removal of 5 items and the modification of 7 items. After discussion within the core group, a final decision was made to remove 5 items. ConclusionBased on a synthesis of IRT and expert consultation feedback, and following discussions within the core group, a revised version comprising 15 items is retained and modified from the original 20 items.
ObjectiveTo explore the use of comprehensive treatment including drugs, devices and electrophysiology for heart failure patients with surgical indications. MethodsWe collected the clinical data of 65 consecutive cardiac surgical patients with chronic left ventricular dysfunction in our department between March 2014 and May 2016. There were 49 males and 16 females with an average age of 61.3±11.4 years ranging from 37 to 80 years. Their left ventricular ejection fraction was less than 40%. Patients with ventricular dysfunction caused by acute myocardial infarction were excluded. A comprehensive treatment strategy was performed according to patients’ individual disease.ResultsFourty patients underwent cardiopulmonary bypass with asisting time of 55-400 (148.1±69.8) min; 35 patients needed cross-clamping with time of 44-203 (95.7±39.6) min. Intra-aortic balloon pump (IABP) was assisted in 3 patients. Two patients died in hospital. During the follow-up of 13.4 months, the patients’ cardiac function significantly improved and the heart size reduced. Two patients died and two were readmitted for heart failure. Four patients underwent cardiac pacemaker implantation. Other patients with unstable symptoms were stabilized after medical dose adjustment.ConclusionUnder the concept of neuroendocrine inhibition, the comprehensive treatment for heart failure can effectively reduce surgical mortality and improve the patient’s quality of life.
Currently, about one-third of patients with anti-epilepsy drug or resective surgery continue to have sezure, the mechanism remin unknown. Up to date, the main target for presurgical evaluation is to determene the EZ and SOZ. Since the early nineties of the last century network theory was introduct into neurology, provide new insights into understanding the onset, propagation and termination. Focal seizure can impact the function of whole brain, but the abnormal pattern is differet to generalized seizure. Brain network is a conception of mathematics. According to the epilepsy, network node and hub are related to the treatment. Graphy theory and connectivity are main algorithms. Understanding the mechanism of epilepsy deeply, since study the theory of epilepsy network, can improve the planning of surgery, resection epileptogenesis zone, seizure onset zone and abnormal node of hub simultaneously, increase the effect of resectiv surgery and predict the surgery outcome. Eventually, develop new drugs for correct the abnormal network and increase the effect. Nowadays, there are many algorithms for the brain network. Cooperative study by the clinicans and biophysicists instituted standard and extensively applied algorithms is the precondition of widely used clinically.
Objective To study the application effect of Snyder hope theory combined with Satir model in the rehabilitation therapy of young and middle-aged patients with stroke. Methods A total of 224 young and middle-aged patients with stroke admitted to Zhongshan Hospital of Fudan University between August 2018 and August 2020 were divided into four groups (control group, Satir group, Snyder group, and combined group) according to the random number table method by taking admission time as sequence. All patients were given rehabilitation training on the basis of conventional treatment, and the Satir group was given group guidance of Satir model, the Snyder group was given hope therapy based on Snyder hope theory, and the combined group was given intervention combined Snyder hope theory with Satir model. All patients were continuously treated for six weeks. The scores of Herth Hope Index (HHI), Self-perceived Burden Scale (SPBS), exercise rehabilitation willingness questionnaire, Health Promoting Lifestyle Profile Ⅱ (HPLP Ⅱ), and Simplified Coping Style Questionnaire (SCSQ) were compared among the four groups before and after intervention. Results There were 53, 52, 54, and 52 patients enrolled in the control group, the Satir group, the Snyder group, and the combined group, respectively. The differences among the four groups in basic information such as sex, age, and type of stroke and the scores of the above scales before intervention were not statistically significant (P>0.05). After intervention, the total scores of HHI scale (27.65±6.34, 30.54±6.85, 32.79±7.12, 35.08±7.63), scores of exercise rehabilitation willingness (39.85±8.16, 40.52±7.93, 40.17±8.25, 43.81±7.46), total scores of HPLP Ⅱ scale (149.87±26.08, 159.32±26.73, 165.89±28.01, 173.18±28.54), and scores of positive coping style of SCSQ scale (19.65±5.08, 22.46±5.29, 25.04±4.91, 28.45±5.12) of the four groups significantly increased compared with those before intervention (P<0.05), while the total scores of SPBS scale (27.35±4.92, 23.74±5.02, 25.16±4.98, 21.49±5.27) and scores of negative coping style of SCSQ scale (4.83±1.25, 3.71±1.02, 3.94±1.08, 4.13±0.96) significantly decreased compared with those before intervention (P<0.05); the scores of HHI scale, exercise rehabilitation willingness, HPLP Ⅱ scale, and positive coping style of SCSQ scale of the combined group were higher than those of the other three groups (P<0.05), while the score of SPBS scale was lower than that of the other three groups (P<0.05). Conclusions Snyder hope theory combined with Satir model for rehabilitation therapy of young and middle-aged patients with stroke can help to improve the hope level, reduce the self-perceived burden, and improve the exercise rehabilitation willingness, health behaviors and coping styles. In addition, it is of great significance for promoting the rehabilitation of patients.
Mitral regurgitation is one of the most common heart valve diseases. Transcatheter edge-to-edge repair (TEER) is currently the most developed and commonly used interventional technique for mitral regurgitation and is recommended by the latest European and American guidelines for patients who are at high surgical risk. TEER device usually consists of a clamping device and a delivery system. The trajectory of the clamping device is called the trajectory, and the trajectory can be well established with the five dimensions movement of the delivery system: left-right oscillation, anterior-posterior oscillation, overall parallel movement, the clamping device's own clockwise rotation, and vertical up-and-down movement. The delivery system's anteroposterior and lateral oscillations are concentrated on the virtual puncture site. Furthermore, the location of the septal puncture site has a significant impact on the establishemnt of the trajectory. The evulation of three variables and adherence to the "4M principles" are necessary for the successful TEER. The three variables are: the position of the clip in the center of the regurgitation,the arm orientation of the clip perpendicular to the boundary of anterior and posterior leaflets, as well as the appropriate length of clamping. The "4M principles" include favorable valve morphology, residual mitral regurgitation below grade 2+, mean transvalvular pressure≤5 mm Hg, and an appropriate amount of leaflets clamping. Patients' baseline situation, the degree of mitral regurgitation and ventricular remodeling, as well as the valve morphology and the outcome of the procedure, are the factors determining the prognosis of patients after TEER.
Family resilience is an important ability for families to cope with stress and adversity. This article systematically sorts out the theoretical system and practical application of family resilience, focusing on the improvement path of family resilience for caregiver. It integrates domestic and foreign research results from the dimensions of theoretical connotation, influencing factors, and intervention projects. Based on the analysis of the systemic deficiencies and weak sustainability of existing intervention plans, this paper proposes a research outlook on the resilience of caregivers’ families in the future, which has important reference value for improving the research paradigm of family resilience.
Mild cognitive impairment (MCI) is a clinical transition state between age-related cognitive decline and dementia. Researchers can use neuroimaging and neurophysiological techniques to obtain structural and functional information about the human brain. Using this information researchers can construct the brain network based on complex network theory. The literature on graph theory shows that the large-scale brain network of MCI patient exhibits small-world property, which ranges intermediately between Alzheimer's disease and that in the normal control group. But brain connectivity of MCI patients presents topologically structural disorder. The disorder is significantly correlated to the cognitive functions. This article reviews the recent findings on brain connectivity of MCI patients from the perspective of multimodal data. Specifically, the article focuses on the graph theory evidences of the whole brain structural and functional and the joint covariance network disorders. At last, the article shows the limitations and future research directions in this field.
As a complex system, the topology of human’s brain network has an important effect on further study of brain’s structural and functional mechanism. Graph theory, a kind of sophisticated analytic strategies, is widely used for analyzing complex brain networks effectively and comparing difference of topological structure alteration in normal development and pathological condition. For the purpose of using this analysis methodology efficiently, it is necessary to develop graph-based visualization software. Thus, we developed VisConnectome, which displays analysis results of the brain network friendly and intuitively. It provides an original graphical user interface (GUI) including the tool window, tool bar and innovative double slider filter, brain region bar, runs in any Windows operating system and doesn’t rely on any platform such as Matlab. When importing the user-defined script file that initializes the brain network, VisConnectome abstracts the brain network to the ball-and-stick model and render it. VisConnectome allows a series of visual operations, such as identifying nodes and connection, modifying properties of nodes and connection such as color and size with the color palette and size double slider, imaging the brain regions, filtering the brain network according to its size property in a specific domain as simplification and blending with the brain surface as a context of the brain network. Through experiment and analysis, we conclude that VisConnectome is an effective visualization software with high speed and quality, which helps researchers to visualize and compare the structural and functional brain networks flexibly.
ObjectiveTo investigate the effect of positive family behavior support on emotional and behavioral problems in preschool children with epilepsy. Methods A total of 80 preschool epileptic children and their parents who were admitted to the Department of Neurology of our hospital from October 2022 to February 2023 were selected as the research objects, and were divided into experimental group and control group with 40 cases each by random number table method. The control group received neurology routine nursing, and the experimental group received positive family behavior support intervention based on the control group. The scores of family intimacy and adaptability scale, strengths and difficulties questionnaire, medication compliance and quality of life of epilepsy children were compared before and after intervention between the two groups. ResultsAfter intervention, the scores of strength and difficulty questionnaire in experimental group were lower than those in control group (P<0.05), and the scores of family intimacy and adaptability scale, quality of life and medication compliance in experimental group were higher than those in control group (all P<0.05). ConclusionThe application of positive family behavior support program can reduce the occurrence of emotional behavior problems, improve family closeness and adaptability, improve medication compliance, and improve the quality of life of preschool children with epilepsy.
Objective To explore the influencing factors of the usage behavior of the scientific research management system and provide references for hospitals in constructing scientific research management systems. Methods Data were collected through questionnaires in April 2024. Based on the unified theory of acceptance and use of technology (UTAUT), the information system success model, and the self-efficacy theory, a research model on the influencing factors of the usage behavior of the scientific research management system among medical staff was constructed from the dual perspectives of users and information systems. The structural equation model was utilized to explore the influencing factors of the usage behavior of the scientific research management system. Results A total of 527 questionnaires were collected. Among them, there were 157 males and 370 females. The overall Cronbach α coefficient of the questionnaire was 0.916, and the KMO value was 0.896. For Bartlett’s test of sphericity (P<0.001). The composite reliability of each latent variable was greater than 0.7, and the average variance extracted was greater than 0.5. Therefore, this questionnaire had good reliability and validity. The research showed that information quality, performance expectancy, effort expectancy, and system quality all had significant positive impacts on the usage intention of users of the scientific research management system (P<0.05). Meanwhile, facilitating conditions and usage intention both had significant positive impacts on the usage behavior of users (P<0.05). Conclusions The construction of the scientific research management system should be guided by management needs, comprehensively sort out the general scientific research work needs of medical staff. Through the apply information-based means, various forms of training, and strengthening policy guidance, the aim is to improve the intelligence level of system operations, enhance the convenience of user self-service, and promote the effective construction of the ecosystem of the scientific research management system.
